35 inpatient physician coder jobs found

If you are an experienced medical coder who thrives in a complex academic medicine environment, this is an opportunity to make a meaningful impact behind the scenes of world-class patient care. Your expertise will help support accurate reimbursement, documentation integrity, regulatory compliance, and the financial health of a nationally recognized academic health system. As a Coding Quality Specialist 3 , you will leverage advanced coding expertise in cardiology services, cardiac, thoracic and vascular surgical procedures, catheter-based procedures, diagnostic testing, and evaluation & management services . This remote role offers the opportunity to work with highly specialized physician services while partnering with providers and operational teams to ensure coding accuracy, compliance, and excellence across the revenue cycle. The Role In this highly specialized coding position, you will perform professional fee coding and quality review functions for complex...

Responsibilities Atlantic Region CBO: The Atlantic Region Central Billing Office (“ARCBO”) or (“CBO”) provides business office services including billing, collections, cash posting, pre-access management, variance, and customer service to our affiliated Universal Health Services hospitals. https://jobs.uhs.com/atlantic-region-cbo The Atlantic Region CBO is seeking a dynamic and talented Inpatient Coder for our Appeals department. The primary responsibility of the DRG Coder is to analyze third party coding audits of paid claims, draft detailed appeal letters, evaluate clinical level of care and review denial trends. Key Responsibilities include: Perform DRG (Diagnosis Related Group) validation reviews in response to audits from third party payers. Review audit findings letters from third party payers to obtain a clear understanding of audited diagnosis codes and underlying payer clinical / coding rationale. Analyze medical records to obtain supporting clinical documentation...

City/StateVirginia Beach, VAWork ShiftFirst (Days)Overview:Sentara Medical Group is now hiring a full-time hybrid Risk Adjustment Coder in Virginia Beach, VA!Hours: Monday - Friday, dayshift.This is a hybrid position that offers a combination of remote and onsite work, with a requirement to be in the office one to two days each week or must be able to do site visits. The role also includes travel as needed to support business objectives and team collaboration.OverviewPerforms compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories...

Inpatient Coder (Remote)Full-time • Work From HomeMust have CCS, RHIA, or RHIT certificationJob SummaryAs a Coding Integrity Specialist III WORK FROM HOME, you will review and evaluate hospital inpatient medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM and ICD-10-PCS codes. A CIS III performs coding and/or code/DRG validation across multiple entities by applying all appropriate coding guidelines and criteria for code selections.Job QualificationsAssign, sequence, validate, and/or edit codes/DRGs and abstracted data (e.g., physician, discharge disposition, query tracking) for inpatient records for multiple facilities using ICD-10-CM and ICD-10-PCSMaintain or exceed established accuracy standardsMaintain or exceed established productivity standardsUtilize the complete patient medical record documentation in code/DRG assignment, validation, and/or editing of codes/DRGsUndergraduate (Associate's or Bachelor's) degree in HIM/HIT...

Responsibilities One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $15.8 billion in 2024. UHS was again recognized as one of the World's Most Admired Companies by Fortune; listed in Forbes ranking of America's Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. The Atlantic Region CBO is seeking a dynamic and talented Inpatient Coder for our Appeals department. This...

## Risk Adjustment CoderApplyremote type: Hybridlocations: SMG Administrationtime type: Full timeposted on: Posted Todayjob requisition id: JR-103351**City/State**Virginia Beach, VA**Work Shift**First (Days)**Overview:**# **Overview**Performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories (HCC). Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits, provider engagement, & all risk adjustment ICD-10-CM coding-related activities. Conducts annual risk assessments,...

Sentara Medical Group is now hiring a full-time hybrid Risk Adjustment Coder in Virginia Beach, VA! Hours: Monday - Friday, 8:00AM -5:00PM, dayshift. This is a hybrid position that offers a combination of remote and onsite work, with a requirement to be in the office one to two days each week. The role also includes travel as needed to support business objectives and team collaboration. Overview Performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories (HCC). Supports risk adjustment data validation (RADV), medical record...

Medical Coding Professional 2The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues.As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS leaders and champions to identify STARS gaps and deficiencies.The...

Job Description Job Description Description:   Charge Capture and Claim Submission Review and verify charges, CPT/ICD-10/HCPCS codes, and modifiers for orthopedic office visits, procedures, injections, imaging, DME, and surgical services before billing. Prepare, scrub, and submit clean claims to commercial, government, and third-party payers through athenaOne, resolving claim edits and clearinghouse rejections promptly. Track global surgical periods, bundling rules, and payer-specific requirements to ensure correct billing for orthopedic procedures. Denial Management and Appeals Work denials, rejections, kicked claims, and no-response claims daily in athenaOne; determine the kick reason and root cause, correct, and resubmit within payer timely-filing limits. Draft and submit appeals with supporting documentation, including for medical-necessity, authorization, coordination-of-benefits, and downcoding denials common in orthopedics. Route registration-driven denials...

Coder III (Remote) (Medical Coding Specialist, Certified Professional Coder, Medical Billing and Coding Specialist, Inpatient Coding Specialist) Job Category : Non-Clinical Requisition Number : CODER013949 Posted : September 23, 2026 Full-Time Remote Locations Showing 1 location Fishersville, VA 22939, USA Pay or shift range: $25.18 USD to $38.53 USD The pay range reflects the current compensation range for this position at the time of posting. Individual offers are determined based on directly related experience, skills, education, internal equity, and other job-related factors. Not all candidates will qualify for the upper end of the posted range. Description Overview At Augusta Health, your work matters — and so do you. Whether you're delivering direct patient care, supporting operations, or innovating behind the scenes, every role contributes to our mission of promoting wellness and healing through compassionate service. We offer more than just a job — we offer a...

78 Medical Center Drive, Fishersville, VA 22939, USA At Augusta Health, your work matters — and so do you. Whether you're delivering direct patient care, supporting operations, or innovating behind the scenes, every role contributes to our mission of promoting wellness and healing through compassionate service. We offer more than just a job — we offer a purpose-driven career in a nationally recognized, independent health system located in Virginia’s scenic Shenandoah Valley. Our team members thrive in a supportive culture that values collaboration, integrity, and excellence. With opportunities across clinical and non-clinical areas, Augusta Health is a place where your skills make a difference, and your growth is a priority. Why Join Augusta Health? We believe in taking care of the people who care for our community. That’s why Augusta Health offers a comprehensive and thoughtfully designed benefits package that supports your well‑being, career development, and work‑life...

Pay or shift range: $23.02 USD to $35.22 USD The pay range reflects the current compensation range for this position at the time of posting. Individual offers are determined based on directly related experience, skills, education, internal equity, and other job-related factors. Not all candidates will qualify for the upper end of the posted range. Description At Augusta Health, your work matters — and so do you. Whether you're delivering direct patient care, supporting operations, or innovating behind the scenes, every role contributes to our mission of promoting wellness and healing through compassionate service. We offer more than just a job — we offer a purpose-driven career in a nationally recognized, independent health system located in Virginia’s scenic Shenandoah Valley. Our team members thrive in a supportive culture that values collaboration, integrity, and excellence. With opportunities across clinical and non-clinical areas, Augusta Health is a place where your skills...

$45,000 - $50,000 a year About the Role We are seeking an Ambulance and NEMT Billing Coding Specialist to support the revenue cycle for emergency and nonemergency medical transportation services. This position reviews transport documentation, confirms patient and payer information, resolves documentation gaps, prepares accurate claims, and helps move each trip from intake through claim submission and follow-up. The ideal candidate is organized, detail-oriented, comfortable working independently, and able to collaborate with billing leadership, QA and QI staff, dispatchers, field personnel, facilities, transportation brokers, patients, and families. What You Will Do Review ambulance and NEMT transport records for completeness, accuracy, medical-necessity support, and consistency across dispatch records, ePCRs, trip documents, and billing systems. Verify patient demographics, insurance eligibility, payer order, transport type, service level, origin and destination, mileage,...

POSITION SUMMARY Conducts reviews and provides recommended corrections of billed services as it relates to clinical documentation for the VMG enterprise. Assists in the reviews and responses to payor and governmental audits of billed services. Assists the CBO in replying to payor denials and patient inquiries as it relates to services billed. Reviews and research new coding guidelines and codes. Assists the staff of the VHS corporate compliance. EDUCATION CPC (AAPC) required. Degree in Heath Services Management, Business or another related field preferred. Extensive knowledge of ICD-9-CM/ICD-10 CM and CPT coding principles and guidelines required. Extensive knowledge of reimbursement systems required. EXPERIENCE Eight to ten years’ experience (college degree can be substituted for years of experience) and expertise in ICD-9 CM/ICD-10 CM Coding. SPECIAL SKILLS Medical Terminology, ICD-9 CM/ICD-10 CM and CPT-4 Coding, Ability to relate to people and work closely with physicians and...

Job TitleNewport News, Virginia$23.00 - $29.90/Hourly Actual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs.This position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA.OverviewEnsures high quality documentation that is thorough, accurate and complete to ensure correct reimbursement capture. Assigns diagnostic and procedure codes to simple record types up to highly complex record types. Contributes to the proper management of health information through consistent and accurate code assignment processes adhering to all regulatory coding principles, rules and regulations.What You Will DoOrganizes and prioritizes assigned work to ensure that work is completed within the assigned time frame. Reviews charts and entire medical records, assigning ICD and CPT code combinations to each data element. Audits for documentation...

A Coder I performs post claim reviews of denied and retracted claims to identify coding-related issues, determine appropriate corrections, and provide feedback to providers, office staff, billing staff, and other departments. This position supports accurate coding and appropriate reimbursement by reviewing medical record documentation, researching coding guidelines, identifying trends in coding-related denials, and providing education and recommendations to improve coding accuracy and documentation. The Coder I works collaboratively with the Billing team, site staff, providers, and other departments to resolve coding-related issues and support successful claim resolution.Major Duties and ResponsibilitiesMaintains working knowledge of current CPT, HCPCS, ICD-10-CM, medical terminology, and applicable coding guidelines and payer requirements.Reviews denied and retracted claims to identify coding, documentation, modifier, diagnosis, or other claim-related issues contributing to the...

Coding Educator/AuditorInsight Global is seeking a Coding Educator/Auditor for a healthcare system in Virginia. The educator will provide consulting services to physicians, residents, allied health professionals and billing staff to support patient care documentation, coding and billing practices according to federal, state and local regulatory compliance standards.• Creates and delivers presentations to clinical faculty and billing staff.• Develops training programs and delivers training and education sessions for physicians, allied health professionals, residents, and coding and billing staff to support compliance with third party documentation and billing regulatory standards, including but not limited to classroom training, web-based training and one-on-one provider observation and training sessions.• Participates on clinical department Billing Quality Councils as a member of the respective councils and acts as the primary resource providing technical and regulatory expertise...

Our Medical Billing Specialists ensure efficient filing and resolution of insurance claims; acting as liaison between doctors, insurance companies, and patients. Essential Duties and Responsibilities include the following. Other duties may be assigned. Monitors and evaluates insurance reimbursements and requests review of questionable reimbursements on a claim-by-claim basis and by procedure code. Obtains accurate billing information from patients and insurance companies. Consults physicians and/or the coding department for assistance with the resubmission of claims requiring corrected diagnosis or procedure codes and as a resource for additional documentation or letters of inquiry and/or explanation, etc. Manages and researches status reports and the Aged AR to determine and resolve claim issues, denials, and overpayments. Works with insurance carriers and Privia to identify and address major claims issues and policy inconsistencies, escalating when necessary,...

At OrthoVirginia, you’re part of a team dedicated to delivering expert orthopedic and therapy care across the state. As Virginia’s largest provider of musculoskeletal care, we offer full‑time and part‑time opportunities in a collaborative, team‑oriented environment. With more than 159 physicians in over 35 locations—including Lynchburg, Northern Virginia, Richmond, Southwest Virginia, and Hampton Roads—OrthoVirginia is a leader in orthopedic surgery, non‑surgical care, and physical, hand, and occupational therapy. Our nationally recognized specialists treat a full range of musculoskeletal injuries and conditions, helping patients of all ages move, heal, and thrive. Join us and become part of a trusted network committed to excellence in orthopedic care. Primary Functions & Responsibilities: Analyze and interpret patient medical records, visit encounters, and reports to assign and sequence appropriate codes upon reviewing billed information. Ensure ICD-10, CPT, and HCPCS codes...

Fully Remote Lake Park Building Full time R182990 Job Description: The Med Grp Professional Billing (PB) Coder II is responsible for accurately resolving coding edits in assigned Epic WQ's and assigning ICD-10, CPT, and HCPCS coding classifications and modifiers based on clinical documentation and/or physician orders. This role ensures the integrity of data for both internal and external reporting, maintains work queues within processing timeframes, responds to inquiries related to billing codes, and adheres to compliance guidelines. Essential Functions Evaluates and resolves all types of coding edits in assigned Charge Review, Claim Edit, and Follow-up work queues in Epic. Assigns ICD, CPT, and HCPCS coding classifications based on clinical documentation and/or physician orders. Accurately evaluates and resolves assigned coding edits in Charge Review, Claim Edit, and Follow-up work queues in Epic within assigned timeframes. Appropriately...

Summary With direction from the Director, the Nurse Auditor/ Senior Revenue Integrity Specialist is responsible for auditing itemized charges versus the patient medical record and other applicable hospital documentation, assigning modifiers to appropriate claims, researching edited claims for medical necessity, and advising the billing staff of appropriate HCPCS codes and modifiers. The Nurse Auditor/ Revenue Integrity Specialist works directly with revenue producing departments regarding lost charges, billing questions, and proper coding and charging. The nurse auditor reviews documentation on all Observation accounts for carve-out observation hours, the charge coding of ED Visits and Injection and Infusion charges. Essential Duties and Responsibilities Coordinate, supervise, and respond to third party patient bill audits. Perform patient requested audits in a timely manner. Perform random quality audits as schedule permits. Work and review a high volume of accounts assigned to...

Essential Duties and Responsibilities These duties and responsibilities represent the general tasks performed on a daily basis; other tasks may be assigned. Coordinate, supervise, and respond to third‑party patient bill audits. Perform patient requested audits in a timely manner. Perform random quality audits as scheduled. Assist Patient Account personnel with patient questions about itemized charges. Maintain a reporting system of audit activities and identify patterns and trends of results. Act as a resource for all hospital departments with charging questions and issues. Routinely review inpatient and outpatient records for appropriate coding and charging. Provide educational sessions for revenue‑producing departments regarding appropriate charging process and procedures. Work cooperatively with the Patient Accounting staff and other health‑care professionals in obtaining correct HCPCS codes and modifiers. Assist the Health Information Department with RAC requests,...

Coding Specialist (Part-Time)At Commence, we're the start of a new age of data-centric transformation, elevating health outcomes and powering better, more efficient processes to program and patient health. We combine quality data-driven solutions that fuel answers, technology that advances performance, and clinical expertise that builds trust to create a more efficient path to quality care.With human-centered, healthcare-relevant, and value-based solutions, we create new possibilities with data. We provide proof beyond the concept and performance beyond the scope with a focus on efficiencies that transform the lives of those we serve. With a culture driven by purpose, straightforward communication and clinical domain expertise, Commence cuts straight to better care.The Coder Reviewer position is responsible for supporting and conducting reviews and determinations for independent dispute resolutions at both the Federal and State levels. Subject matter expert in clinical...

Certified CoderAt Commence, we're the start of a new age of data-centric transformation, elevating health outcomes and powering better, more efficient processes to program and patient health. We combine quality data-driven solutions that fuel answers, technology that advances performance, and clinical expertise that builds trust to create a more efficient path to quality care.With human-centered, healthcare-relevant, and value-based solutions, we create new possibilities with data. We provide proof beyond the concept and performance beyond the scope with a focus on efficiencies that transform the lives of those we serve. With a culture driven by purpose, straightforward communication and clinical domain expertise, Commence cuts straight to better care.The Certified Coder performs coding-focused medical review of Medicare Part A/B and DMEPOS claims for the program. Certified coders apply Medicare policies and guidelines, ensuring claims are evaluated according to National and Local...